DirectTrust Reports Record High Exchange Activity in 2025

Nearly 1.9 billion Direct Exchange Transactions Recorded

Published on Feb. 10, 2026

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DirectTrust, a non-profit healthcare industry alliance, announced full-year 2025 metrics from its accredited Health Information Service Provider (HISP) members, highlighting record-high Direct exchange activity in 2025 and continued growth in the use of the DirectTrust national network for secure, interoperable Direct exchange of health information.

Why it matters

The growth in Direct exchange volume reflects increased adoption and sustained, real-world use to support critical healthcare, social care, and public health use cases. As new applications like Electronic Case Reporting continue to expand, Direct remains a proven, reliable foundation for interoperable data exchange.

The details

In 2025, a total of 1.894+ billion Direct Secure Messages were exchanged - an average of over 157 million messages per month - representing the highest annual transaction volume recorded to date and a 42% increase from the previous year. The number of trusted Direct addresses able to securely exchange protected health information (PHI) reached more than 3.1 million in Q4 2025, reflecting continued expansion of trusted, identity-assured Direct endpoints across the network.

  • In 2025, a record number of Direct Secure Messages were sent and received across the DirectTrust network.
  • The number of trusted Direct addresses reached more than 3.1 million in Q4 2025.

The players

DirectTrust

A non-profit, vendor-neutral alliance dedicated to establishing trust in a connected world, serving as a forum for a consensus-driven community focused on health communication and cybersecurity, an ANSI standards development organization, an accreditation and certification body, and a developer of technical trust frameworks and supportive services for secure information exchange.

Scott Stuewe

President and CEO of DirectTrust.

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What they’re saying

“We're encouraged by the continued growth and scale of Direct exchange across the DirectTrust network. In 2025, we saw the highest annual transaction volume to date, reflecting not just increased adoption, but sustained, real-world use to support critical healthcare, social care, and public health use cases.”

— Scott Stuewe, President and CEO of DirectTrust (DirectTrust)

The takeaway

The growth in Direct exchange transactions highlights the increasing importance of secure, interoperable data exchange in supporting critical healthcare, social care, and public health workflows. As new applications continue to emerge, DirectTrust's national network remains a reliable foundation for facilitating these vital exchanges.